Psych key points Flashcards
Global memory impairment over a very short period of time with sleep/appetite loss and worried about poor memory
Pseudodementia (Severe depression)
Insomnia, irritability, anxiety, tremor, loss of appetite, tinnitus, perspiration, perceptual disturbances, seizures
Benzodiazepine withdrawal syndrome
Schneider’s first rank symptoms
Auditory hallucinations, passivity phenomena, thought disorder, delusional perception (sky is blue therefore I am king)
Persistent belief in the presence of an underlying serious disease and patient refuses to accept reassurance or negative test results
Hypochondrial disorder
Multiple physical symptoms present for at least 2 years and patient refuses to accept reassurance or negative test results
Somatisation disorder
Loss of motor or sensory function and the patient doesn’t consciously feign the symptoms or seek material gain
Conversion disorder
Separating off certain memories from normal consciousness and involves amnesia, fugue or stupor
Dissociative disorder
Selective serotonin re-uptake inhibitors
Citalopram
Fluoxetine - for children and adolescents
Sertraline
SEs - GI bleeding
Interactions - NSAIDs, triptans, aspirin, heparin, warfarin
Monoamine oxidase inhibitors
Selegiline
Rasagiline
Not used much
SEs - avoid cheese
Serotonin-noradrenaline re-uptake inhibitors
Venlafaxine
Duloxetine
Tetracycines
Amitryptiline
Clomipramine
Imipramine
SEs - drowsiness, dry mouth, constipation, urinary retention, blurred vision
Typical antipsychotics
Chlorpromazine
Haloperidol - prolonged QT syndrome
SEs - extrapyramidal side effects (Parkinsonism, acute dystonia, tardive dyskinesia, akathisia), antimuscarinic (urinary retention, blurred vision), weight gain, neuroleptic malignant syndrome, increased risk of venous thromboembolism
Atypical antipsychotics
Olanzapine
Quetiapine
Clozapine - agranulocytosis
Mood stabilisers
Lithium
Sodium valproate
Lamotrigine - during pregnancy
Management of generalised anxiety disorder
Step 1 - education about GAD + active monitoring
Step 2 - low intensity psychological interventions (individual non-facilitated self-help or individual guided self-help or psychoeducational groups)
Step 3 - high intensity psychological interventions (CBT or applied relaxation) or sertraline
Step 4 - MDT
Management of panic disorder
Step 1 - recognition and diagnosis
Step 2 - SSRIs (if not effective after 12 wks or contraindicated start Imipramine)
Step 3 - review and consideration of alternative treatments
Step 4 - review and referral to specialist mental health services
Step 5 - care in specialist mental health services
Difference between mania and hypomania
Grandiose delusions in mania and not in hypomania
Looking for personal gain
Factitious/Munchausens
Looking for external gain (money, drugs)
Malingering
Alcohol withdrawal timeline
6-12 hours - symptoms
36 hours - seizures
72 hours - delirium tremens - give chlordiazepoxide
SSRI discontinuation syndrome
Increased mood change, restlessness, difficulty sleeping, unsteadiness, sweating, diarrhoea, vomiting,
paraesthesia
SSRIs in pregnancy
First trimester - increased risk of congenital heart defects
Third trimester - persistent pulmonary hypertension of the newborn
Paroxetine has an increased risk of congenital malformations
